| NPI | 1316164155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2008-00672) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: WV 24142) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2014-07-03 |