| NPI | 1790189199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME133247) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME133247) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 100021227) | |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2018-03-17 |