| NPI | 1679192165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX W5713) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: FL 161854) | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2026-07-21 |