| NPI | 1760091573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD482346) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 8282-851) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2023-10-17 |