| NPI | 1679130991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102207214) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116033179) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2024-06-27 |