| NPI | 1053051599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA12738200) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NJ 25MA12738200) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2025-07-22 |