| NPI | 1699228734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC 87072) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 87072) |
| 208D00000X General Practice (Licence: NY 296938-1) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2024-09-10 |