| NPI | 1497149355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME148439) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 274198) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2021-09-02 |