| NPI | 1912227281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2013-00636) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 165150) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2021-03-29 |