| NPI | 1104086636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 149765) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 149765) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2015-01-08 |