| NPI | 1699361022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: VT 055.0031551) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: VT 055.0031551) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: VT 055.0031551) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207QA0000X Family Medicine, Adolescent Medicine (Licence: VT 055.0031551) | |
| Enumeration Date | 2020-12-20 |
| Last Update Date | 2023-11-26 |