| NPI | 1609446681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 340029) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD486356) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2026-01-14 |