| NPI | 1659952919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: MN 72898) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2024-10-03 |