| NPI | 1518652247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.152424) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 35.152424) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2026-02-28 |