| NPI | 1821654740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 23175) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 23175) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 15004-I) | |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2024-06-17 |