| NPI | 1366700833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2015-00207) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 182620) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2016-12-14 |