| NPI | 1912643214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 20A23823) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R3731) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2025-02-17 |