| NPI | 1700400355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61323217) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML61066174) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA ML61066174) | |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2022-07-25 |