| NPI | 1396192431 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0086980)  | 
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MD D0086980)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-18 | 
| Last Update Date | 2019-06-13 |