| NPI | 1508433392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351050407) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-12158) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2022-11-22 |