| NPI | 1942643671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA OS017896) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: DE C70005293) | |
| 208000000X Pediatrics (Licence: PA OT015333) | |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2016-07-07 |