| NPI | 1831525948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: FL ME149703) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN19440) |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2021-06-08 |