| NPI | 1548843568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS024029) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA OS024029) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2024-10-08 |