| NPI | 1194138313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 287963) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME144585) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN 19751) | |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2021-01-07 |