| NPI | 1922799220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 343348) |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2026-05-22 |