| NPI | 1477202752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4351054096) |
| Additional Taxonomies | 261QS1000X Clinic/Center Student Health |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2025-06-19 |