| NPI | 1588318414 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program | 
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 23017)  | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 16000i)  | |
| Enumeration Date | 2022-02-09 | 
| Last Update Date | 2023-06-30 |