| NPI | 1356886089 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2019038861) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2019022202) | 
| Enumeration Date | 2017-01-04 | 
| Last Update Date | 2020-06-25 |