| NPI | 1710183397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 57514) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 58885) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: HI DOS-1511) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 058885) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2022-07-21 |