| NPI | 1679828461 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 62272) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL AC3890313-T060) | 
| Enumeration Date | 2012-07-17 | 
| Last Update Date | 2022-07-21 |