| NPI | 1780201145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101274241) |
| 207P00000X Emergency Medicine (Licence: MS T-4138) | |
| 208D00000X General Practice (Licence: MS T-4138) | |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2023-04-11 |