| NPI | 1215677877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 164570) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2023-09-13 |