| NPI | 1861913683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208D00000X General Practice (Licence: NM MD2022-1154) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-09-13 |