| NPI | 1134823933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101289271) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC SMIT-K2LB3D) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2026-06-11 |