| NPI | 1912184516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR do29400) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR ll16582) |
| Enumeration Date | 2008-01-25 |
| Last Update Date | 2009-08-31 |