| NPI | 1346620036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102205692) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA S80546054) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2019-09-16 |