| NPI | 1942869375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.148771) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2022-01268) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT217763) | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2023-09-20 |