| NPI | 1023339603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 254621) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125057613) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2017-11-09 |