| NPI | 1730470774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD168555) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 12334198) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2014-10-15 |