| NPI | 1962999029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME157543) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.141338) |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2022-12-06 |