| NPI | 1104116300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0059037) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.206770) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2021-04-21 |