| NPI | 1477900793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60866702) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11351672-1205) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2021-02-18 |