| NPI | 1063808400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME165201) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 13675 I) |
| 208D00000X General Practice (Licence: PR 19126) | |
| 208D00000X General Practice (Licence: FL ACN731) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN32437) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2024-06-19 |