| NPI | 1477873099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A-12690) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: DE C7-0004560) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2015-01-14 |