NPI | 1952753709 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: PA OT018884) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208000000X Pediatrics (Licence: PA OS019957) | |
Enumeration Date | 2016-07-05 |
Last Update Date | 2021-07-14 |