| NPI | 1265825970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 76056) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 284201-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2025-03-17 |