| NPI | 1609219112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI 18532) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: HI MDR-6474) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2016-08-29 |