| NPI | 1114287067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 284686) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 252412) |
| 207Q00000X Family Medicine (Licence: MA 265247) | |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2016-09-21 |