| NPI | 1528528544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 325562) |
| 208D00000X General Practice (Licence: LA 325562) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2021-05-24 |