| NPI | 1164747481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NE 26440) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 26440) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2025-05-08 |