| NPI | 1588929459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 293190-1) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: MI 4301100597) | |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2018-11-01 |