| NPI | 1184470627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 024501) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 16927-I) |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2025-08-04 |