| NPI | 1760506299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 240919) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301084005) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301084005) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2012-02-24 |