| NPI | 1164586558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME106579) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-087012) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2011-12-09 |