| NPI | 1417586413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: KY 06072) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OK 7967) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2085R0001X (Licence: OK 7967) | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2025-07-01 |