| NPI | 1609289693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 19002) |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine (Licence: NH 19002) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2018-07-17 |