| NPI | 1104116938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CO DR.0056417) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198832) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT198832) | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2016-06-16 |