| NPI | 1386024370 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 294338)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT209229)  | 
| Enumeration Date | 2015-06-04 | 
| Last Update Date | 2019-07-15 |