| NPI | 1497346316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 22641) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 15703I) |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2022-05-19 |