| NPI | 1871079194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301504493) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2018018334) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2022-01-14 |