| NPI | 1528485067 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 270114) | 
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 270114) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-22 | 
| Last Update Date | 2021-02-14 |