| NPI | 1912149964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME 106863) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME106863) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 11276) | |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2021-04-07 |