| NPI | 1124225990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301090110) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301090110) |
| 2080H0002X (Licence: MI 4301090110) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 43301090110) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2015-06-16 |