| NPI | 1164836508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH APP-000133564) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD461538) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT207392) | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2020-07-28 |