| NPI | 1639543572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A15157) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 007595) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2025-10-22 |