| NPI | 1104445113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL ME158502) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: FL ME158502) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: FL ME158502) | |
| 208M00000X Hospitalist (Licence: FL ME158502) | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2025-08-21 |