| NPI | 1073254140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME172305) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 338619) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-04-16 |