| NPI | 1780206078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 105434-1) |
| 208D00000X General Practice (Licence: NY 105434-1) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2022-05-23 |