| NPI | 1912448275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61139634) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 320000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-19 |
| Last Update Date | 2021-08-13 |