| NPI | 1538726831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 21727) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14959) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2020-06-13 |