| NPI | 1194923862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD151090) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2007017298) |
| Enumeration Date | 2007-07-04 |
| Last Update Date | 2020-05-20 |