| NPI | 1508057597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA MD200288) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME 119567) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2014-04-22 |