| NPI | 1821644410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 318072) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 34510R) |
| Enumeration Date | 2019-08-10 |
| Last Update Date | 2025-09-10 |