| NPI | 1124501176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 0011425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.080608) |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2026-07-03 |