NPI | 1235781204 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 21455) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 21455) |
Enumeration Date | 2019-07-10 |
Last Update Date | 2024-10-06 |