| NPI | 1801889456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-0426) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ID MR0836) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2018-08-22 |