| NPI | 1912496522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 323017) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 67567) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2023-07-03 |