| NPI | 1710381926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 76625) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL L.3942R) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2017-01-23 |