| NPI | 1750949467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125074348) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125074348) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 57692) | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2023-04-11 |