| NPI | 1790104321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 64495-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 64495-21) |
| 207P00000X Emergency Medicine (Licence: WI 64495-21) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2025-10-07 |