| NPI | 1053985614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 022865) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 15729-I) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2022-09-05 |