| NPI | 1588958540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A131084) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME12437) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2016-05-19 |