| NPI | 1861788101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR MD168562) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2011018538) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2014-12-22 |