| NPI | 1538258652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101236820) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2011-00574) |
| 208D00000X General Practice (Licence: FL ME130076) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2017-02-16 |