| NPI | 1578204830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10078744) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10078744) |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-15 |