| NPI | 1558927962 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208D00000X General Practice (Licence: FL OS18985)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10068780)  | 
| 207Q00000X Family Medicine (Licence: FL OS18985)  | |
| Enumeration Date | 2019-05-13 | 
| Last Update Date | 2024-01-24 |