| NPI | 1851702112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 67673) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 64444) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2024-03-01 |