| NPI | 1295908879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101265547) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM MD2011-0126) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2019-10-23 |