| NPI | 1447480116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 57409-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 53002) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2021-11-04 |