NPI | 1841722055 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 70805-20) |
Additional Taxonomies | 171000000X Military Health Care Provider |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-03-28 |
Last Update Date | 2022-02-19 |