| NPI | 1336648260 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 23282) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 5080883) | 
| Enumeration Date | 2018-02-06 | 
| Last Update Date | 2024-07-30 |