| NPI | 1992182992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 201800432) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 209853) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2019-07-29 |