| NPI | 1124436753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: FL ME141645) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME141645) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2024-07-16 |