| NPI | 1043451032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 000002352) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: LA 00000000000) | |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2014-12-09 |