| NPI | 1801249636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME155585) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD469016) |
| Enumeration Date | 2016-07-17 |
| Last Update Date | 2023-01-13 |