| NPI | 1104113091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036146888) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301099315) |
| 208000000X Pediatrics (Licence: MI 4301099315) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2021-12-06 |