| NPI | 1093292070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP05185) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.245636) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2021-07-08 |