| NPI | 1114230984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME120647) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 48970) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2018-05-09 |