| NPI | 1760910608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 73106) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 73106) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125070365) | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2022-07-21 |