NPI | 1750670600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: KS 0439609) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208000000X Pediatrics (Licence: LA 300521) | |
Enumeration Date | 2011-03-31 |
Last Update Date | 2017-04-27 |