NPI | 1679036875 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME156583) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A176856) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-13 |
Last Update Date | 2025-06-26 |