| NPI | 1902339591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.151903) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 70434) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2021-03-02 |