| NPI | 1639559651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042-0014938) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT208946) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2020-09-08 |