| NPI | 1316523053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-10593) |
| 208000000X Pediatrics (Licence: MO 2021021968) | |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2024-04-16 |