| NPI | 1093179541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301507279) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 68709) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207Q00000X Family Medicine (Licence: PA MT219804) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2022-11-18 |