| NPI | 1275154007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 104541) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 104541) |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2025-09-19 |