| NPI | 1033402482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 03708) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY R2653) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 390200000x) | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2018-08-22 |