| NPI | 1407410004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 110886) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: NC 202200704) | |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2026-08-19 |