| NPI | 1932661188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL OS18242) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0102206224) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2024-07-08 |