| NPI | 1942939020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ D13191700) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351049427) |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2025-08-07 |