| NPI | 1659534089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2012-01053) |
| 208000000X Pediatrics (Licence: NC 2012-01053) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2014-10-13 |