| NPI | 1629699020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2023-00398) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 261494) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2023-08-11 |