| NPI | 1629280839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 41241) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 31693) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125051460) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-10-23 |