| NPI | 1942874748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS23274) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0008874) |
| 207Q00000X Family Medicine (Licence: CO DR.0071497) | |
| 207Q00000X Family Medicine (Licence: ID O-2008) | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2026-04-02 |