| NPI | 1851035653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-01198) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC PUGH-ZNTNW6) |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2024-05-27 |