| NPI | 1972208486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 0077244) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2026-04-25 |