| NPI | 1962821637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM md2017-0100) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2014-0405) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2017-07-12 |