| NPI | 1295268209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME158357) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 305657) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2025-05-08 |