| NPI | 1003437187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 60963) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KY R6499) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2025-07-01 |