| NPI | 1780037317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 292339) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 70595) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2022-09-12 |