| NPI | 1891289492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 49579) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351043818) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301114939) | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2022-09-06 |