| NPI | 1710617063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 86495-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351049111) |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2026-08-12 |