| NPI | 1104278621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME151594) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT211860) |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2021-10-28 |