| NPI | 1215599808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 22789) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 35464-R) |
| 208D00000X General Practice (Licence: PR 35464-R) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-07-03 |
| Last Update Date | 2023-06-23 |