| NPI | 1043941792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 23585) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 16217I) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2023-12-18 |