| NPI | 1285166892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 157516) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 61312) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2022-06-29 |