| NPI | 1801187059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2014-00111) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 172764) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2014-07-30 |