| NPI | 1619321007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-01064) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101267203) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2023-04-07 |