| NPI | 1316399546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME143677) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 21196) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2022-07-27 |