| NPI | 1902434624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 77992) |
| Additional Taxonomies | 208VP0000X (Licence: CT 77992) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2024-08-06 |