| NPI | 1720560659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2023-02539) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 39020) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2023-09-25 |