| NPI | 1629464284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2025-03459) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 149458) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207Q00000X Family Medicine (Licence: OR MD202966) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2026-03-09 |