| NPI | 1588303713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116038162) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2020017680) |
| Enumeration Date | 2022-06-04 |
| Last Update Date | 2023-07-18 |