| NPI | 1922671270 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301512431) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4350148059) | 
| Enumeration Date | 2021-07-22 | 
| Last Update Date | 2024-08-08 |