| NPI | 1255869772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 311695) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD475653) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY P05936) | |
| Enumeration Date | 2017-05-29 |
| Last Update Date | 2023-05-26 |