| NPI | 1184201071 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101027900) | 
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101027900) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-26 | 
| Last Update Date | 2024-06-07 |