| NPI | 1972181352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 32119) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 77950-21) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2024-09-27 |