| NPI | 1710564232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 325608) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2023-09-05 |