| NPI | 1881058055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 312335) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD467541) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 827893095) | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2021-09-20 |