NPI | 1982284618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 98411) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207Q00000X Family Medicine (Licence: PA MT222920) | |
Enumeration Date | 2021-04-08 |
Last Update Date | 2024-02-16 |