| NPI | 1811556137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.145216) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI EMC0002961) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.248363) | |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2024-01-12 |