| NPI | 1710220108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 301613) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 289037) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2020-03-13 |