| NPI | 1235711219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208D00000X General Practice (Licence: MA 1016262) |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2024-01-17 |