| NPI | 1124780887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208D00000X General Practice (Licence: OK 8602) |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2025-01-23 |