| NPI | 1154733079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A168871) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 25111) |
| 208000000X Pediatrics (Licence: GU M-2075) | |
| 208000000X Pediatrics (Licence: AZ 54559) | |
| 208000000X Pediatrics (Licence: HI MD-19081) | |
| 208000000X Pediatrics (Licence: ID M-16696) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2022-08-30 |