| NPI | 1396442273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC PURA-C3W7X6) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2022039228) |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2024-04-06 |