| NPI | 1467447110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AK 5518) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ID MR0833) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2012-12-18 |