| NPI | 1952553745 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO207354) | 
| Additional Taxonomies | 171100000X Acupuncturist (Licence: CO ACU-1427) | 
| 171100000X Acupuncturist (Licence: CA 12652) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-10-13 | 
| Last Update Date | 2022-12-02 |