NPI | 1114110566 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MN 52714) |
Additional Taxonomies | 208000000X Pediatrics (Licence: GA 002802) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 52714) | |
Enumeration Date | 2007-08-20 |
Last Update Date | 2013-07-19 |