| NPI | 1083000608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD464270) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE FC7973654) |
| 208000000X Pediatrics (Licence: DE C7-0005924) | |
| 208000000X Pediatrics (Licence: PA HS000240L) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2020-06-11 |