| NPI | 1891132833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2017-00778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2017-00778) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 191431) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2020-01-03 |