| NPI | 1073071478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 34.016375) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 1073071478) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208D00000X General Practice (Licence: FL 17462) | |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2023-10-16 |