| NPI | 1467017202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 13639) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 68781) |
| 207Q00000X Family Medicine (Licence: MN 29888) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2022-11-07 |