| NPI | 1073005922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME155700) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125072672) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2022-07-18 |