| NPI | 1407506041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME182143) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 79946) |
| Enumeration Date | 2022-03-26 |
| Last Update Date | 2026-07-31 |