NPI | 1790210045 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 19172) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 86343) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-25 |
Last Update Date | 2023-09-26 |