| NPI | 1114312907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME168839) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 294509-1) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2025-06-23 |