| NPI | 1255990644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 318493) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ME TP19027) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2026-04-12 |