| NPI | 1770115057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 36166) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 6411627) |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2022-09-21 |