| NPI | 1740350198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME175633) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 196448) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2026-01-28 |