| NPI | 1568951952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 92041) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101026460) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2022-11-14 |