| NPI | 1407346752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 287493) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA L-275662) |
| Enumeration Date | 2018-05-12 |
| Last Update Date | 2021-07-22 |