| NPI | 1760002216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2024-00684) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2024-00684) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 261105) | |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2024-11-06 |