| NPI | 1609078831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A115072) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME131841) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-06-15 |