| NPI | 1891956322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-00260) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 149966) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2021-03-31 |