| NPI | 1023336526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD181636) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2013-01312) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 164529) | |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2017-07-05 |