| NPI | 1528472032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 19860) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: FL 19860) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-06-12 |