| NPI | 1649474487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2009-00408) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2009-00408) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2013-07-12 |