| NPI | 1518134212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 33391) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2009-01481) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 135460) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2020-12-10 |