| NPI | 1912134503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 324174) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC DC039779) |
| 207Q00000X Family Medicine (Licence: MD D83055) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 390200000X) | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2020-09-04 |