| NPI | 1295170256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME160682) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 276951) |
| Enumeration Date | 2013-05-05 |
| Last Update Date | 2023-02-28 |