| NPI | 1417219544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME123275) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 17400) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2015-03-31 |