| NPI | 1215425053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 202101708) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 1215425053.) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2021-12-13 |