| NPI | 1033643721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY TP936) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: MI 5101025694) | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2022-07-06 |