| NPI | 1023759875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME169623) |
| 208D00000X General Practice (Licence: PA MD487532) | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-12-23 |