| NPI | 1962495945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME100474) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 230844) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2017-02-21 |