| NPI | 1548558638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME129123) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 275967) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2023-07-13 |