| NPI | 1063031375 |
|---|---|
| Former Name | SOFIA D GILLUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01088275A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2023-02-28 |