| NPI | 1285122085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 83728) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO7517) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2021-05-25 |