| NPI | 1245767037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A170139) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT213262) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-09-11 |