| NPI | 1053871202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME155674) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 250310) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2024-07-02 |