| NPI | 1700382967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: IL 036161267) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.071777) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: UT 12194791-1204) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2022-08-04 |