| NPI | 1972036879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A166928) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY J15674970) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2020-09-02 |