| NPI | 1750840500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 318426) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 64216) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2022-08-27 |