| NPI | 1649664657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME132002) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 262217) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2019-06-20 |