| NPI | 1417217084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WV 29892) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: GA 009134) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2020-07-28 |