| NPI | 1396053104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 72834) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 029374) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2023-07-25 |