| NPI | 1821364290 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MN 59815)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 59815)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-03-29 | 
| Last Update Date | 2025-04-28 |