| NPI | 1215390927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 53099) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY TP09) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2024-09-04 |