| NPI | 1588729891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME78173) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME78173) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2022-07-21 |