| NPI | 1609516095 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036175017) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA Pending) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-01 | 
| Last Update Date | 2025-06-25 |