| NPI | 1619289683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 54038) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 4383) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2016-08-03 |