| NPI | 1710500392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0101277954) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2020018947) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2023-07-03 |