| NPI | 1548901705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 189626) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA 189626) |
| Enumeration Date | 2022-04-04 |
| Last Update Date | 2026-07-15 |