| NPI | 1366938425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME168091) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY P10440) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2024-09-09 |