| NPI | 1265842637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2017-00416) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 201369) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2021-05-10 |