| NPI | 1417518671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 22138) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 22138) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2023-06-21 |