| NPI | 1225665193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 338520) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL83967) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC 83967) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2023-09-20 |