| NPI | 1467508077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2009-0565) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-2210) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2010-03-23 |