| NPI | 1972083988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 22320) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14720I) |
| 208D00000X General Practice (Licence: PR 22320) | |
| Enumeration Date | 2018-08-19 |
| Last Update Date | 2025-11-20 |