| NPI | 1790349520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 55653) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R4991) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2022-06-06 |