| NPI | 1982023453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.153953) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS14753) |
| 207Q00000X Family Medicine (Licence: WI 71756-21) | |
| 207Q00000X Family Medicine (Licence: NY 287471-01) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2021-08-23 |