NPI | 1366836975 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 55929) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208000000X Pediatrics (Licence: UT 13249097-1205) | |
208000000X Pediatrics (Licence: IL 125.066855) | |
Enumeration Date | 2015-03-20 |
Last Update Date | 2023-06-14 |