| NPI | 1659804433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 67139) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME145769) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2022-09-06 |