| NPI | 1134885825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351049272) |
| 207Q00000X Family Medicine (Licence: NY P112949) | |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2025-07-03 |