| NPI | 1073253241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MA 3015469) |
| 207R00000X Internal Medicine (Licence: MA 1022386) | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-10-21 |