| NPI | 1528588134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MB10777800) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A19239) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-24 |
| Last Update Date | 2022-09-07 |