| NPI | 1841655784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 43960) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 125.073796) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2022-08-30 |