| NPI | 1346935756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: IA DO-55677) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2026-05-13 |