| NPI | 1023455136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 89490) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME125917) |
| 207Q00000X Family Medicine (Licence: FL TRN 20139) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2024-05-17 |