| NPI | 1043605447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.157682) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN APPLIED FOR) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2021-08-04 |