| NPI | 1104069806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 251174) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 62865) |
| 208000000X Pediatrics (Licence: NY 263478) | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2012-08-06 |