| NPI | 1982265278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.145418) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.145418) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: OH 35.145418) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11020783A) | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2022-07-04 |