| NPI | 1164632881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 64705) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.202984) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2014-03-18 |