| NPI | 1396486759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD489175) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: DE C7-0017902) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT225713) | |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2025-06-12 |