| NPI | 1063054369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM MD2023-0645) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2019-0914) |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2023-06-16 |