| NPI | 1174513683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME 67853) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 196994 1) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2007-07-08 |