| NPI | 1619219995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: WV 29025) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: OH 129015) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2022-04-13 |