| NPI | 1720428642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61395606) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD11111) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2023-03-15 |