| NPI | 1275192528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT019161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS022152) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2026-07-01 |