| NPI | 1831362359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 48942) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO application pending) |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2014-12-16 |