| NPI | 1154663664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 81452) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 054947) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2025-07-08 |