| NPI | 1811636970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 105527) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 35199) |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2025-08-06 |