| NPI | 1902190648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 257926) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10039696) |
| Enumeration Date | 2011-05-29 |
| Last Update Date | 2015-07-30 |