| NPI | 1972972669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD480270) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 4940) | |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2023-07-03 |