| NPI | 1053014092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY NY) |
| 207P00000X Emergency Medicine (Licence: VT VT) | |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2026-06-08 |