| NPI | 1144762998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 279924) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL L.4438R) |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2019-09-20 |