| NPI | 1417533423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME176626) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 77379) |
| Enumeration Date | 2021-03-20 |
| Last Update Date | 2025-09-22 |