| NPI | 1003175654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WV 27872) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 27872) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2021-12-28 |