| NPI | 1992362800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME157899) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 2018012083) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN30216) | |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2023-06-16 |