| NPI | 1952926347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301508539) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351046493) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046493) | |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2023-05-01 |