| NPI | 1669052395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2024-01708) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC HOLT-MT57T6) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2024-07-26 |