| NPI | 1942684923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301107317) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301107317) |
| Enumeration Date | 2015-07-19 |
| Last Update Date | 2018-07-06 |