| NPI | 1710042395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 042.0012581) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 57285) |
| 207R00000X Internal Medicine (Licence: WI 50660-20) | |
| 208000000X Pediatrics (Licence: VT 042.0012581) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 39020000X) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2022-11-17 |