| NPI | 1992904247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2007-01260) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 2007-01260) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2022-02-01 |