| NPI | 1376168880 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN42492) | 
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01094880A) | 
| Enumeration Date | 2020-06-10 | 
| Last Update Date | 2025-09-02 |