| NPI | 1699894360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: RI MD15039) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ME 015709) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2021-04-14 |