| NPI | 1821012121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME134156) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 240023) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-06-10 |