| NPI | 1578192449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 76291) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 8456) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2023-07-10 |