| NPI | 1548580806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME124105) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116022415) |
| 208000000X Pediatrics (Licence: VA 0101253861) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2015-12-09 |