| NPI | 1194380519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME177888) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2026-05-06 |