| NPI | 1609992536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 76977) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 51970) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-10-02 |