| NPI | 1346501905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 264757) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 253036) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2017-01-06 |