NPI | 1467730416 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 53495) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125059059) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 53495) | |
Enumeration Date | 2011-07-25 |
Last Update Date | 2014-09-26 |