| NPI | 1629418694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME141078) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 052271) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2019-11-20 |