| NPI | 1366029910 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0102208625)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA 0102208625)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-28 | 
| Last Update Date | 2025-09-05 |