| NPI | 1689049652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 05073) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.00608546) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2021-09-21 |