| NPI | 1659060119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 023978) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: PR 001288) |
| 363AM0700X Physician Assistant, Medical (Licence: PR 502-PA) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 16556-I) | |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2024-07-16 |