| NPI | 1063909711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: KS 04-46667) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208D00000X General Practice (Licence: MO 2018017386) | |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2022-11-02 |