| NPI | 1104212695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME140460) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL me140460) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2019-06-26 |