| NPI | 1831404524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101262389) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA09176000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2019-04-08 |