| NPI | 1063402733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ME MD17760) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 39491) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2026-05-18 |