| NPI | 1730594458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1013196) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856591) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2023-09-18 |