| NPI | 1902119316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P5840) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301096213) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301096213) | |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2023-04-10 |