| NPI | 1265870703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 25541) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MD H0082469) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2025-10-16 |