| NPI | 1437565371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME141474) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 19678) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2022-10-11 |