| NPI | 1366855793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: OR 194118) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207R00000X Internal Medicine (Licence: MA 259987) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2020-10-13 |