| NPI | 1295143758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 019508) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 31113-R) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2017-12-01 |