| NPI | 1639751001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2024-00468) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC BORC-YZVEJX) |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-03-12 |