| NPI | 1023312832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME131259) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 550256) |
| Enumeration Date | 2011-01-08 |
| Last Update Date | 2021-03-17 |