| NPI | 1598225997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 93422) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208D00000X General Practice (Licence: GA 93422) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2023-08-04 |