| NPI | 1821229873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 300909) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301093934) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2017-04-11 |