| NPI | 1457589277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.098429) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT194893) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2020-12-29 |