| NPI | 1174725204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: FL ME124406) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 9838) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2017-01-17 |