| NPI | 1912567298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2023-02747) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 2023-02747) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 34247-R) | |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2023-09-27 |