| NPI | 1487357653 |
|---|---|
| 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: WA 70111069) |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2026-05-20 |