| NPI | 1104358514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 88674) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: OH 35.138771) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2026-06-15 |