| NPI | 1841619848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 61835) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2014-0296) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2018-03-17 |