| NPI | 1740784446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD479117) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME147119) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: NJ 25MA1132700) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2023-01-27 |