| NPI | 1851640775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 55733) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN17755) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: CT 55733) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2018-12-10 |