| NPI | 1497888630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 048675) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 430188134) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2010-09-13 |