| NPI | 1417303561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 28839) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2016-05-08 |
| Last Update Date | 2025-09-30 |