| NPI | 1194429290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2026028283) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 100277) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2026-06-30 |