| NPI | 1235361999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P3965) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME113359) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2013-03-21 |