| NPI | 1295316248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 125.077557) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.077557) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-07-31 |