| NPI | 1023207511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A97292) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME 113649) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2018-07-30 |