| NPI | 1609967488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM RS) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 057669) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-06-29 |