| NPI | 1770073868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 344566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0090745) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2025-01-08 |