| NPI | 1497288799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AL 39359) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI 22673) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2024-07-08 |