| NPI | 1558948760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2024025625) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: CO 0010575) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2025-07-05 |