| NPI | 1649620626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 64602) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 300650) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2022-07-03 |