| NPI | 1366928210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 1688522) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.140558) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.245377) | |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2022-01-04 |