| NPI | 1225418783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME140991) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301114068) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-31 |
| Last Update Date | 2020-11-11 |