| NPI | 1154014611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5151016230) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA DO.OP.70139738) |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2026-09-10 |