| NPI | 1063014892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: KY 58897) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 31635) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2024-09-30 |