| NPI | 1740625557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101265684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 26906) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2023-11-08 |