| NPI | 1699093864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME122808) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.206594) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2020-09-11 |