| NPI | 1710337696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME149199) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 267862) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2021-07-29 |