| NPI | 1316375637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME155956) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 19571) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2022-09-14 |