| NPI | 1730355512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 241765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A112814) |
| 208000000X Pediatrics (Licence: MA 241765) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2021-12-15 |