| NPI | 1306043682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 344720-1205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019749) |
| 207P00000X Emergency Medicine (Licence: VA 0101246455) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2014-11-03 |