| NPI | 1053060657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-161099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT MED-RES-LIC-113355) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2025-07-10 |