| NPI | 1205416765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 86003) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL86003) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2024-06-28 |