| NPI | 1053995100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1019811) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT021192) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2024-0263) | |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2024-07-09 |