| NPI | 1134625189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2021-0491) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: NM MD2021-0491) | |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2025-10-23 |