| NPI | 1972923829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME132517) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A147566) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2022-04-18 |