| NPI | 1124600093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 76819) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN X000-057-306-400) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2024-07-19 |