NPI | 1649590068 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: FL ME114250) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME114250) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN15002) | |
Enumeration Date | 2010-06-08 |
Last Update Date | 2020-11-19 |