| NPI | 1083140735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2020-00637) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 227073) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2020-06-15 |