NPI | 1396275228 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD478707) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 61063) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT213578) | |
Enumeration Date | 2017-06-13 |
Last Update Date | 2023-07-06 |