| NPI | 1215228895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME142902) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 003955) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2020-04-22 |