| NPI | 1629509823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-43009) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KS 94-09151) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2020-06-08 |