| NPI | 1780985606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 20818) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 12,705-I) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2014-05-29 |