| NPI | 1336529650 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS14302) | 
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL OS14302) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-06-02 | 
| Last Update Date | 2025-04-02 |