| NPI | 1205419595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL OS19765) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208D00000X General Practice (Licence: LA 342942) | |
| 207U00000X Nuclear Medicine (Licence: FL OS19765) | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2026-03-27 |