| NPI | 1861122079 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX W0746) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351050123) | 
| Enumeration Date | 2022-06-13 | 
| Last Update Date | 2025-09-02 |