| NPI | 1891218541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2023001239) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0444948) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KS 94-09574) | |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2023-02-02 |