| NPI | 1619361128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME136352) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 99403) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2024-04-16 |