| NPI | 1831456805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 62820) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 62820) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 000) | |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2018-01-10 |