| NPI | 1245469626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME112055) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2009015020) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2012-11-02 |