| NPI | 1265967053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 86507) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 228306) |
| Enumeration Date | 2017-04-29 |
| Last Update Date | 2020-09-21 |