| NPI | 1699066340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208D00000X General Practice (Licence: LA MD.207362) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2017-03-31 |