NPI | 1013114263 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: SC 30795) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC 30795) |
Enumeration Date | 2007-06-29 |
Last Update Date | 2020-10-14 |