| NPI | 1548535800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 81618) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 45369) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN 13410) | |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2019-08-26 |