| NPI | 1215425996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL 1102) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14388-I) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2018-11-21 |