| NPI | 1659785103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 163991) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01077946A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11017833A) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2021-12-07 |