| NPI | 1578146197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NE 2786) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 2786) |
| 207Q00000X Family Medicine (Licence: NE 9089) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NE 2786) | |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2025-08-12 |