| NPI | 1700521218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA 1700521218) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT021491) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-10-07 |