| NPI | 1629522172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101275998) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 57544) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2023-06-01 |