| NPI | 1417440967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2021-01662) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT018624) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 254004) | |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2021-11-24 |