| NPI | 1750842621 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 34.015658)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.030797)  | 
| Enumeration Date | 2019-03-25 | 
| Last Update Date | 2022-06-21 |