| NPI | 1790362630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 78969) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 330959) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-02-18 |