| NPI | 1174253793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 24448) |
| Additional Taxonomies | 261QP0905X Clinic/Center, Public Health, State or Local |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2025-09-02 |