| NPI | 1154530236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA OP60077117) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58002134) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2018-03-17 |