| NPI | 1124450374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 19050) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 19050) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 29319-R) | |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2024-02-06 |