| NPI | 1356319149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME161877) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD453017) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 161877) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-10-29 |