| NPI | 1033177118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME107976) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 164691) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2013-07-31 |