| NPI | 1720212400 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME121332)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT196050)  | 
| Enumeration Date | 2009-05-08 | 
| Last Update Date | 2015-07-19 |