| NPI | 1487130761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL OS16872) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO5765) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2020-07-30 |