| NPI | 1770963399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME134919) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN# 21594) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2018-04-15 |