| NPI | 1093268468 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301119017) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301109762) | 
| Enumeration Date | 2016-08-02 | 
| Last Update Date | 2019-06-21 |