| NPI | 1467716811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 270117) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN16258) |
| 208000000X Pediatrics (Licence: FL ME120161) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2021-05-26 |