| NPI | 1942434493 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME147444) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 280116) | 
| 207R00000X Internal Medicine (Licence: WV 25871) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-13 | 
| Last Update Date | 2021-01-12 |