| NPI | 1740521525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101256759) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: VA 0101256759) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2023-10-19 |