NPI | 1437470549 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 070368) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 070368) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2010-06-13 |
Last Update Date | 2015-03-16 |