| NPI | 1609243013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 36392) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: MO 2018041052) | |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2024-07-15 |