| NPI | 1871703611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 54654) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11012619A) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-01-23 |