| NPI | 1780845917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036132135) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 148760) |
| 208000000X Pediatrics (Licence: NC 2011-00835) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2013-07-26 |