NPI | 1962015479 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.084058) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 3304880) |
Enumeration Date | 2020-08-25 |
Last Update Date | 2024-06-17 |