| NPI | 1114478567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 24740) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 24740) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2022-00885) | |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2026-04-10 |