| NPI | 1689161663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD28155) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 66354) |
| 207Q00000X Family Medicine (Licence: MI 4301504299) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2024-04-24 |