| NPI | 1861772964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME 120774) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 271907) |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2021-03-02 |