| NPI | 1770844342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2015-00797) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 182312) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2023-06-01 |