| NPI | 1356769467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 65436) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD461644) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2019-06-10 |