| NPI | 1558855387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.170528) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301504083) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL L.4749) | |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2024-08-19 |