| NPI | 1891174462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 62193) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 59390) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2019-01-23 |