| NPI | 1275875650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO CDRH.0062267) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL OS13837) |
| 208000000X Pediatrics (Licence: CO DR.0062267) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO3449) | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2021-10-01 |