| NPI | 1508480138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301509586) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046931) |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2023-06-13 |