| NPI | 1902484629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MN 79810) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 81492-20) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2025-06-04 |