| NPI | 1366006843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MT218068) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C7-0007057) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-06-18 |