| NPI | 1710220231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 3083) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN K211150836404) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2017-03-06 |