| NPI | 1063972164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 2022-00367) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2022-00367) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2024-08-02 |