| NPI | 1700939568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME123259) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 131798) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2022-07-21 |