| NPI | 1396066890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301096303) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 34663685) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2013-04-29 |