| NPI | 1306145156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.120795) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 57856) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2023-11-03 |