| NPI | 1467629170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME116346) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 264329) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2013-11-04 |