| NPI | 1164044285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GU DO-0126) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL000) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2024-05-29 |