| NPI | 1174104541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301517725) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2026-06-17 |