| NPI | 1902061898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR md153081) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR LL18121) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR LL18121) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2011-12-14 |