| NPI | 1548356660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME114819) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 221922) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2014-08-29 |