| NPI | 1174765580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 70757) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2014026585) |
| 208000000X Pediatrics (Licence: KS 0437465) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208000000X Pediatrics (Licence: WI 55412) | |
| 208000000X Pediatrics (Licence: IA 41012) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2022-03-28 |