| NPI | 1619170396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2010-00558) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019216) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2010-08-31 |