| NPI | 1760624506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME143615) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 27890) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2021-11-11 |