| NPI | 1366646440 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2022007571) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101016575) | 
| 207R00000X Internal Medicine (Licence: CA 20A11086) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101016575) | |
| Enumeration Date | 2007-06-13 | 
| Last Update Date | 2025-08-27 |