| NPI | 1902366420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 1.071465) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 1.071478-RES) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2022-08-23 |