| NPI | 1154583607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 247367) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP01371) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2017-01-09 |