NPI | 1629481023 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MD D92770) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208000000X Pediatrics (Licence: NJ 25MA09894300) | |
Enumeration Date | 2014-06-04 |
Last Update Date | 2021-11-10 |