NPI | 1922532654 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME144274) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 227433) |
Enumeration Date | 2017-04-19 |
Last Update Date | 2021-03-22 |