| NPI | 1174901458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME140045) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 295980) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2019-07-25 |