| NPI | 1972445435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125087997) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 125.087997) |
| Enumeration Date | 2026-04-06 |
| Last Update Date | 2026-06-12 |