| NPI | 1093392938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2021020561) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-10528) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2021-06-22 |