| NPI | 1558716449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 070458) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 218498) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2023-02-13 |