| NPI | 1700060787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 050760) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA PGY.1.TUL-PEDS) |
| 208000000X Pediatrics (Licence: LA MD.203198) | |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2022-09-13 |