NPI | 1689161663 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD28155) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301504299) |
207Q00000X Family Medicine (Licence: MN 66354) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-16 |
Last Update Date | 2024-09-12 |