| NPI | 1093704769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME 108078) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 204659) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2019-06-10 |