| NPI | 1063900959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME158288) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 63170) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2025-11-15 |