| NPI | 1558866988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-46896) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2021025345) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2022-10-13 |