| NPI | 1801161948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ACN1563) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9105601) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2023-09-08 |