| NPI | 1417245267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 007534) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 967) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2020-01-18 |