| NPI | 1801655956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2024021571) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 94-12008) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2024-06-27 |