| NPI | 1497327662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 339522) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OT020989) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2026-03-05 |