| NPI | 1710205034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.206688) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 206688) |
| 207Q00000X Family Medicine (Licence: MS 22866) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2018-03-17 |