| NPI | 1063033892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 60047) |
| Additional Taxonomies | 208D00000X General Practice (Licence: KY 60047) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2025-05-22 |