| NPI | 1659534956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME171244) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 306248) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2025-08-28 |