| NPI | 1467232702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY P124920) |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2024-04-05 |