| NPI | 1104350412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2022-1222) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA12290000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2026-01-29 |