| NPI | 1164716205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 248583) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 248583) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |