| NPI | 1790913028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 15499) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NH RT 1931) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2014-01-20 |