| NPI | 1912386434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: FL ME157652) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME157652) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2022-09-12 |