| NPI | 1083233860 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208D00000X General Practice (Licence: MA 1016459) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2020-04-13 | 
| Last Update Date | 2023-08-02 |