| NPI | 1659639532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 61465-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 61465-20) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2021-01-15 |