| NPI | 1013961705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME129459) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME129459) |
| 174400000X Specialist (Licence: NJ 25MA05448300) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-05-30 |