| NPI | 1992164230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 19408) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 32243R) |
| 208D00000X General Practice (Licence: PR 19408) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 13519i) | |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2019-08-12 |