| NPI | 1659945061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351047897) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351047897) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2022-09-14 |