| NPI | 1114977790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME78762) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME78762) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2018-03-17 |