| NPI | 1164047197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 29405) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MS 29405) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2023-07-03 |