| NPI | 1518343243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: FL ME136285) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| 208000000X Pediatrics (Licence: FL ME136285) | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2019-10-18 |