| NPI | 1215382619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME138414) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN 22648) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2019-07-03 |