| NPI | 1972867091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO173663) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA OL60296010) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2021-02-18 |