| NPI | 1235669508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL me145059) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME145059) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN24879) | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2025-02-27 |