NPI | 1033641774 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1014133) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208000000X Pediatrics (Licence: OH 35.138934) | |
Enumeration Date | 2017-03-31 |
Last Update Date | 2023-06-04 |