| NPI | 1912354267 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S1912) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10056861) | 
| Enumeration Date | 2016-05-17 | 
| Last Update Date | 2019-09-10 |