| NPI | 1326482464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CO DR.0059161) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.021330) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2020-11-17 |