| NPI | 1366977969 |
|---|---|
| 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: CT 69352) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2022-12-13 |