| NPI | 1114191079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME115157) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 247497) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2024-08-27 |