| NPI | 1063918993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2026-00416) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2021-0531) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2026-05-15 |