| NPI | 1366905457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 291591) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ME MD28295) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2026-04-27 |