| NPI | 1215370929 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R3689) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2013-0377) | 
| Enumeration Date | 2013-04-11 | 
| Last Update Date | 2021-12-14 |