| NPI | 1578701223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 47960) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2022-06-17 |