| NPI | 1750641783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2015-01126) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 182647) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2023-09-27 |