| NPI | 1548421704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 2581891) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 00000000) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2020-05-05 |