| NPI | 1063943777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-02792) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL DO.1933) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2022-12-22 |