| NPI | 1043524556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX S7739) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301096217) |
| 208000000X Pediatrics (Licence: NH 16423) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301096217) | |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2024-07-30 |