| NPI | 1689916801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 20391) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 0438748) |
| 208000000X Pediatrics (Licence: MO 2016023059) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2021-03-09 |