| NPI | 1194455667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT225494) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD490658) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2026-05-12 |