| NPI | 1790120970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-20436) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD186779) |
| 207Q00000X Family Medicine (Licence: CA A135743) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2021-06-09 |