| NPI | 1174822969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 38479) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: NY 269498) | |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2017-01-30 |