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 |