| NPI | 1366903916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 57230) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY R5045) |
| 207R00000X Internal Medicine (Licence: VA 0101287723) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2026-02-25 |