| NPI | 1508203274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS018197) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT 015101) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2016-06-07 |