| NPI | 1891178448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 65763) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 65763) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2022-05-25 |