| NPI | 1518321264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: DC MD047596) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA 29261824) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2021-06-07 |