| NPI | 1659637676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: OK 29068) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2017-05-02 |