| NPI | 1669819355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 89803) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 36080) |
| 207Q00000X Family Medicine (Licence: NC 2016-00355) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2021-10-27 |