NPI | 1821595687 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA11866600) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207Q00000X Family Medicine (Licence: PA MD474471) | |
Enumeration Date | 2018-04-09 |
Last Update Date | 2023-08-18 |