| NPI | 1295963635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2012-00116) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 156952) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2012-10-10 |