| NPI | 1093961716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME126655) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 272237) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2016-12-06 |