| NPI | 1124471743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 21011) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21011) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14235I) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2021-06-08 |