| NPI | 1023373735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME158088) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0081796) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2024-01-05 |