| NPI | 1245477231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME135556) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME135556) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2018-05-31 |