| NPI | 1023751849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 338922) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0009212) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2026-05-12 |