| NPI | 1629199385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2010-01858) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME119940) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2017-06-23 |