| NPI | 1679951438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 134059) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MT MED-RES-LIC 52169) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2018-10-08 |