| NPI | 1487002309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD468232) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT211219) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2019-10-29 |