| NPI | 1730592288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 60746951) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301105799) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301105799) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2022-02-04 |