NPI | 1104386804 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA11480800) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-03-20 |
Last Update Date | 2023-04-26 |