| NPI | 1770110744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: WV 4495) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: FL OS0021069) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-12-03 |