| NPI | 1679136196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: KY 61423) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: KY 61423) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2026-03-03 |