| NPI | 1396239323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME135843) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 135843) |
| 208000000X Pediatrics (Licence: PR 18517) | |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2024-05-08 |