| NPI | 1114556206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 1017378) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2024-07-31 |