| NPI | 1538393129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 47387) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 47389) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2021-09-25 |