| NPI | 1790003473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA 264288) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 264288) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2022-12-12 |