| NPI | 1578081618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 82941) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD36346) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2025-06-19 |