| NPI | 1477832012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 64064) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 311024) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-08-14 |
| Last Update Date | 2019-09-10 |