| NPI | 1558929893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: KY 58646) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21469) |
| 208D00000X General Practice (Licence: FL ACN1440) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14862) | |
| Enumeration Date | 2019-06-02 |
| Last Update Date | 2024-03-07 |