| NPI | 1366644460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 68041) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME101766) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2022-01-10 |