| NPI | 1700248739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 299976) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2020-06-23 |