| NPI | 1841953965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 8832) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OK 8832) |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2026-02-11 |