| NPI | 1073711768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 249948) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D66354) |
| 208000000X Pediatrics (Licence: FL ME 107469) | |
| 208000000X Pediatrics (Licence: AK 6712) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-07-21 |