| NPI | 1457886988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN DO4055) |
| 207Q00000X Family Medicine (Licence: KY 05159) | |
| 207Q00000X Family Medicine (Licence: KY TP411) | |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2025-08-07 |