| NPI | 1134019391 |
|---|---|
| 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: MO 2025027733) |
| Enumeration Date | 2025-07-08 |
| Last Update Date | 2025-07-08 |