| NPI | 1255696134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.126623) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301100244) |
| Enumeration Date | 2012-07-07 |
| Last Update Date | 2023-11-03 |