NPI | 1972128619 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351046665) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046665) |
Enumeration Date | 2020-06-09 |
Last Update Date | 2020-08-06 |