| NPI | 1801322516 |
|---|---|
| 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: NY 300671) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2021-07-19 |