| NPI | 1659802429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics (Licence: CA 20A17090) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 17090) |
| 208000000X Pediatrics (Licence: WA 61066147) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2025-05-30 |