| NPI | 1790201770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-01892) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL l4436R) |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2022-02-17 |