| NPI | 1962142794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 81627) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2022-0690) | |
| 207Q00000X Family Medicine (Licence: NM MD2025-0815) | |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2026-02-04 |