| NPI | 1649469693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 64667) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS10239) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO1175) | |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2020-04-07 |