| NPI | 1518311919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036150387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN X324293532409) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 62592) | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2020-08-25 |