| NPI | 1215546999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 281011) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 90971) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2023-04-28 |