NPI | 1043779200 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: GA 92606) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA MDRE.ML.60950738) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 92606) | |
Enumeration Date | 2019-03-18 |
Last Update Date | 2023-10-12 |