| NPI | 1265163349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101285101) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116036751) |
| 207Q00000X Family Medicine (Licence: VA 0116036751) | |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2025-03-24 |