| NPI | 1316327018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD 086870) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 273814) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT209461) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2022-09-09 |