| NPI | 1366935728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2021-01976) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 239129) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2023-05-04 |