| NPI | 1710112610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2012-01003) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 156809) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2015-01-20 |