| NPI | 1780171751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CO DR.0065037) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0007050) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2020-09-23 |