| NPI | 1447340773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 67374) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME103758) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2012-07-30 |