| NPI | 1134644727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 21153) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21153) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2024-01-10 |