| NPI | 1275941544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME131973) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL ME131973) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN 19990) | |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2020-07-24 |