| NPI | 1568791036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60353072) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 56781) |
| 208000000X Pediatrics (Licence: MN 56781) | |
| 208000000X Pediatrics (Licence: WA MD60353072) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-12-13 |
| Last Update Date | 2022-11-09 |