| NPI | 1528102506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 41502) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TN MD0000041502) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2012-07-11 |