| NPI | 1366892127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V4688) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME142035) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2024-12-17 |