| NPI | 1972711679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 14724) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 222361) |
| 207Q00000X Family Medicine (Licence: MA 235298) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2017-05-08 |