| NPI | 1245896174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 280817) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101276544) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2024-05-15 |