| NPI | 1215192224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 313913) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 003099) |
| 207Q00000X Family Medicine (Licence: IA 39778) | |
| Enumeration Date | 2008-07-20 |
| Last Update Date | 2021-12-28 |