| NPI | 1447601653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME150634) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2019-01783) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2021-12-27 |