| NPI | 1265059281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 22771) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 35044R) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2022-06-17 |