| NPI | 1639457484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 280044) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: MN 57497) | |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2016-05-25 |