| NPI | 1548907199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: WI 101144851) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022022480) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2024-07-15 |