| NPI | 1760861553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 81717) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD-46664) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10054462) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2023-08-24 |