| NPI | 1235628769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 68043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101275152) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2022-05-12 |