| NPI | 1629455316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2019-00567) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 273577) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 263503) | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2021-06-09 |