| NPI | 1912434192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A164237) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351029954) |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2020-08-11 |