| NPI | 1043708340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX T3456) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301114615) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301114615) | |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2022-12-05 |