| NPI | 1447677992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: PA MD460390) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: PA MT212704) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-22 |
| Last Update Date | 2018-10-15 |