| NPI | 1689105769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD480549) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 272481) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA S69718078) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2023-04-06 |