| NPI | 1619610573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2025-01150) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2025-01150) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2025-09-11 |