| NPI | 1922585934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 22518) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14764) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2022-03-01 |