| NPI | 1063154854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A187959) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GU TLL-2025-005) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 390200000X) | |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2025-09-08 |