| NPI | 1447877949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 23111) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 15482-I) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 23111) | |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2024-04-30 |