| NPI | 1912682394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 84759) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 100011851) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2025-04-28 |