| NPI | 1902462005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D94461) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 280679) |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2022-09-30 |