| NPI | 1356758213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME163801) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2016-0909) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 63433) | |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2024-01-31 |