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 |