| NPI | 1659950483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 0077638) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2026-06-30 |