| NPI | 1457779357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 274046) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 274046) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2024-04-03 |