| NPI | 1700397825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.259516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11022510A) |
| 101YM0800X Counselor Mental Health (Licence: OH C.1300114) | |
| 207QA0401X Family Medicine Addiction Medicine (Licence: OH 57.259516) | |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2025-07-30 |