| NPI | 1467499384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME94271) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME94271) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-06-16 |