| NPI | 1649264250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME112348) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 258268) |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2013-08-07 |