| NPI | 1508486648 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 17327) | 
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MD 2355572) | 
| 183700000X Pharmacy Technician (Licence: MD T29369) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-18 | 
| Last Update Date | 2025-07-02 |