| NPI | 1164803268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me135130) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN# 21415) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-06-16 |