| NPI | 1972923456 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: VA 0101262781)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2014-04-23 | 
| Last Update Date | 2017-07-06 |