| NPI | 1851746234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-79230) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MT Med-Res-Lic 52130) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2022-02-23 |