| NPI | 1851595045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI 15172) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: HI 5049) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2021-09-22 |