| NPI | 1366790602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C154644) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036.135494) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10040551) | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2020-07-01 |