NPI | 1205063914 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09086100) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT194274) |
Enumeration Date | 2009-06-20 |
Last Update Date | 2016-12-29 |