| NPI | 1679199665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SD 15084) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046846) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2024-08-21 |