| NPI | 1578839395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2016-00092) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2016-00092) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2018-06-07 |