| NPI | 1861785552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME119856) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 16300) |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2015-07-13 |