| NPI | 1770147084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-02565) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 88310) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2024-12-24 |