| NPI | 1285384289 |
|---|---|
| Former Name | MIRA ELIZABETH NICCHITTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2025-01091) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2025-06-30 |