| NPI | 1184720203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME105530) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 202351) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2012-01-06 |